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In an open letter to Jim Plagakis, a JP fan decides that even when a paradigm is shattered, there is still value to be had in picking up the pieces.

In an open letter to Jim Plagakis, a JP fan decides that even when a paradigm is shattered, there is still value to be had in picking up the pieces.

Dear Jim:

Recently I reread your column "Paradigm Lost," which Drug Topics published back in March [JP at Large]. It got me thinking.

I work an overnight pharmacist job at a hospital near Atlanta, Ga. I have a 7-on, 7-off schedule (since last May) and have put in over 10 years at the hospital (filling various slots in the schedule).

The need for speed

I know the issues connected with not being fast enough. This past March we had a child in our neonatal ICU who needed to be taken to a local children's hospital, and I had to get many drugs ready for her as we worked to get her stable enough for transport. 

That weekend we also had two "Code Blue" situations at the hospital, and I did all I could on my own. Both events happened after midnight, when my techs were gone. Alas, those situations became matters of "We did all we could, too."

Chop or juggle; just stay out of the ER

Sometimes my job can be characterized as "chop wood and carry water." Other times it’s like that old joke about "juggling a chainsaw, a machete, a tiki torch, and an apple at the same time, doing your best to eat the apple as you juggle."

So I can understand a lot of what you said in "Paradigm Lost."  When I read about your frustration during your visit the ER, I could identify. In late 2000 I had to go to the ER of the hospital where I worked at the time; a wound in my right hand needed to be stitched up. My experience wasn't as bad as the one you described in your column, but it was bad enough.

Like you, at times I have felt that I had a duty to my community and colleagues - meaning that I had to suck it up if I felt the stress building up and trying to get to me. (Once done with work, I figuratively threw up later.)

A little peace would be nice

All in all, I have what others think of as charmed circumstances: a good job with folks who appreciate the fact that I try to help them and their patients (even if they don't always say so as often as I would like), and a boss and colleagues in my pharmacy who appreciate my role. At times I even discover a willingness to step outside my comfort zone.

But a few times, we get thrown into things in a hospital that don’t make it easy.

I just keep praying for guidance, strength, and maybe just a little peace in which to get things done.

Stay calm and carry on

As I said, I know that feeling you wrote about, especially when the patient count in the hospital is higher than in past years, or when the needs for care dramatically increase in quantity.

And if you have a drug that's on back-order? You find out what the "coin of the realm" is, and just hope you can get what you need for your patients.

As Lisa Cuddy told Gregory House in an episode of "House, M.D.": "I looked into that philosopher you quoted [Mick Jagger], and you're right, you can't always get what you want, but if you try sometimes, you might find you get what you need." 

That’s all I ask, getting what I need for those who depend upon me - and asking for patience from the other staff if it takes longer to get the meds I need for them. (And asking for the option of substitution, if I can't find a supply source that will let me have the drugs in question).

We just need to keep trying, 'cause sometimes we do find we get what we need.

Theodore Hsu, RPh, is staff pharmacist at a medical center in Covington, Ga.


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